Consensus on the management of advanced radioactive iodine-refractory differentiated thyroid cancer on behalf of the Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and Spanish Rare Cancer Working Group (GETHI)

Abstract

Thyroid cancer is the single most prevalent endocrine malignancy; differentiated thyroid cancer (DTC) accounts for more than 90 % of all malignancies and its incidence has been rising steadily. For more patients, surgical treatment, radioactive iodine (RAI) ablation, and thyroid-stimulating hormone (TSH) suppressive therapy achieve an overall survival (OS) rate of 97.7 % at 5 years. Nevertheless, locoregional recurrence occurs in up to 20 % and distant metastases in approximately 10 % at 10 years. Two-thirds of these patients will never be cured with radioactive iodine therapy and will become RAI-refractory, with a 3-year OS rate of less than 50 %. Over the last decade, substantial progress has been made in the management of RAI-refractory DTC. Given the controversy in some areas, the Spanish Task Force for Thyroid Cancer on behalf of Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and the Spanish Rare Cancer Working Group (GETHI) have created a national joint task force to reach a consensus addressing the most challenging aspects of management in these patients. In this way, multidisciplinary management should be mandatory and nuclear medicine targeted therapy, novel molecular targeted agents, and combinations are currently changing the natural history of RAI-refractory DTC.

Successful pregnancy without disease progression of radioiodine refractory papillary thyroid carcinoma: a case report

“…Although the prognosis of RR-PTC is poorer than well differentiated individuals, patients may also live for a long time with stable disease [ 1 ]. Therefore, the impact of potential pregnancy on the prognosis of RR-PTC should be disclosed.…”

“…With the development of diagnostic technology, increasing number of patients was diagnosed as radioiodine refractory papillary thyroid carcinoma (RR-PTC) with relatively poor prognosis [ 1 ]. However, to date, few data can be referred to predict the outcome of RR-PTC in patients who will undergo pregnancies.…”

lncRNA CASC2 Enhances 131I Sensitivity in Papillary Thyroid Cancer by Sponging miR-155

“…Radioiodine ( 131 I) exposure is the standard adjuvant treatment for patients with thyroid cancer [ 3 ]. However, some patients would fail to respond to 131 I therapy with an overall survival less than 50% due to the local recurrence and distant metastasis [ 4 ]. Noncoding RNAs are associated with PTC development and can enhance 131 I therapeutic function and improve the survival of patients [ 5 – 7 ].…”

Exploiting Ret Isoforms in Managing Medullary and Papillary Thyroid Cancer

“…Surgical removal of the thyroid, followed by postoperative thyroid hormone replacement therapy, contributes to successful disease management in the majority of both PTC and MTC cases [2]. However, a subset of patients experience recurrence and/or distant metastases [2,3]. To date, additional treatment strategies, such as external beam radiation or chemotherapy, have had limited efficacy and are associated with adverse effects [2,3] posing an urgent need for predictive markers to distinguish treatment-resistant cases, as well as new treatment options for these persistent thyroid cancers.…”

“…However, a subset of patients experience recurrence and/or distant metastases [2,3]. To date, additional treatment strategies, such as external beam radiation or chemotherapy, have had limited efficacy and are associated with adverse effects [2,3] posing an urgent need for predictive markers to distinguish treatment-resistant cases, as well as new treatment options for these persistent thyroid cancers. The advent of methodologies to target common oncogenic proteins or mutants that contribute to thyroid cancers is providing new therapeutic opportunities to address these challenging cases.…”